Figure and Ground Perception
Figure 5.1 This figure demonstrates the alternation of figure and ground perception. Do you see the vase or the face? Keep looking. Now what do you see now? You will probably notice that the vase and face alternate but cannot be perceived at the same time. This is a useful concept in understanding how fear is uncoupled from immobility. When one experiences pure immobility, one cannot (like vase and face) also feel fear at the same time. This facilitates expansion and the gradual discharge of activation shown in Figure 5.2.
Step 3. Pendulation and containment: the innate power of rhythm
Expecting the worst, you look, and instead, here’s the joyful face you’ve been wanting to see.
Your hand opens and closes and opens and closes.
If it were always a fist or always stretched open,
you would be paralyzed.
Your deepest presence is in every small contracting and expanding.
The two as beautifully balanced and coordinated as birdwings.
—Rumi (1207–1273)
All God’s children got rhythm, who could ask for anything more?
—Porgy and Bess
While trauma is about being frozen or stuck, pendulation is about the innate organismic rhythm of contraction and expansion. It is, in other words, about getting unstuck by knowing (sensing from the inside), perhaps for the first time, that no matter how horrible one is feeling, those feelings can and will change. Without this (experienced) knowledge, a person in a state of “stuckness” does not want to inhabit his or her body. In order to counter the seemingly intractable human tendency to avoid horrible and unpleasant sensations, effective therapy (and the promotion of resilience in general) must offer a way to face the dragons of fear, rage, helplessness and paralysis. The therapist must inspire trust that their clients will not be trapped and devoured by first giving them a little “taste treat” of a pleasant internal experience. This is how our clients move toward self-empowerment. Confidence builds with the skill of pendulation.
One surprisingly effective strategy in dealing with difficult sensations involves helping a person find an “opposite” sensation: one located in a particular area of the body, in a particular posture, or in a small movement; or one that is associated with the person’s feeling less frozen, less helpless, more powerful and/or more fluid. If the person’s discomfort shifts even momentarily, the therapist can encourage him to focus on that fleeting physical sensation and so bring about a new perception; one where he’s discovered and settling on an “island of safety” that feels, at the very least, OK. Discovering this island contradicts the overarching feelings of badness, informing the person that somehow the body may not be the enemy after all. It might actually be grasped as an ally in the recovery process. When enough of these little islands are found and felt, they can be linked into a growing landmass, capable of withstanding the raging storms of trauma. Choice and even pleasure become a possibility with this growing stability as new synaptic connections are formed and strengthened. One gradually learns to shift one’s awareness between regions of relative ease and those of discomfort and distress.
This shifting evokes one of the most important reconnections to the body’s innate wisdom: the experience of pendulation, the body’s natural restorative rhythm of contraction and expansion that tells us that whatever is felt is time-limited … that suffering will not last forever. Pendulation carries all living creatures through difficult sensations and emotions. What’s more, it requires no effort; it is wholly innate. Pendulation is the primal rhythm expressed as movement from constriction to expansion—and back to contraction, but gradually opening to more and more expansion (see Figure 5.2). It is an involuntary, internal rocking back and forth between these two polarities. It softens the edge of difficult sensations such as fear and pain. The importance of the human ability to move through “bad” and difficult sensations, opening to those of expansion and “goodness,” cannot be overstated: it is pivotal for the healing of trauma and more generally, the alleviation of suffering. It is vital for a client to know and experience this rhythm. Its steady ebb and flow tell you that, no matter how bad you feel (in the contraction phase), expansion will inevitably follow, bringing with it a sense of opening, relief and flow. At the same time, too rapid or large a magnitude of expansion can be frightening, causing a client to contract precipitously against the expansion. Hence, the therapist needs to moderate the scale and pace of this rhythm. As clients perceive that movement and flow are a possibility, they begin to move ahead in time by accepting and integrating current sensations that had previously overwhelmed them.
Cycles of Expansion and Contraction
Figure 5.2 This figure describes the cycle of expansion and contraction through the process of pendulation. This vital awareness lets people learn that whatever they are feeling will change. The perception of pendulation guides the gradual contained release (discharge) of “trauma energies” leading to expansive body sensations and successful trauma resolution.
Let’s look at three universal situations that register this innate capacity of pendulation to restore feelings of relief and life flow: (1) We have all watched the inconsolable anguish of a child who, after a nasty fall, runs screaming to its mother and collapses in her arms. After a short time, the child begins to orient back out to the world, then seeks a moment’s return to its safe haven (perhaps through a glance back at mother or a connection through touch); and then, finally, returns to play as if nothing ever happened. (2) Consider the adult who is struck down by the gut-wrenching reaction to the sudden loss of a loved one. One may collapse, feeling that this experience will go on forever, resulting in one’s own death. Grieving can stretch out for quite a long time, but there is a clear ebb and flow in the tide of anguish. Gradually the rhythm of acceptance and pain yields a calming release and a return to life. (3) Finally, recall the last time you were driving and experienced a shockingly close call with disaster. Your nerves were raw with fear (hair standing on end) and rage, and your heart was pounding wildly, ready to explode in your chest. Then a wave of relief reminded you that you haven’t been catapulted into the horror of an accident. This moment of relief is usually followed by a second “flashback” of the near miss, which provokes another round of lessened startle, followed by yet another wave of restorative relief. This reparative rhythm occurs involuntarily, usually in the shadow of awareness, thankfully allowing one to focus on the task at hand. Thus, pendulation allows you to recover your balance and return to life’s moment-to-moment engagement.
When this natural resilience process has been shut down, it must be gently and gradually awakened. The mechanisms that regulate a person’s mood, vitality and health are dependent upon pendulation. When this rhythm is experienced, there is, at least, a tolerable balance between the pleasant and the unpleasant. People learn that whatever they are feeling (no matter how horrible it seems), it will last only seconds to minutes. And no matter how bad a particular sensation or feeling may be, knowing that it will change releases us from a sense of doom. The brain registers this new experience by tuning down its alarm/defeat bias. Where before, there was overwhelming immobility and collapse, the nervous system now finds its way back toward equilibrium. We cease to perceive everything as dangerous, and gradually, step by step, the doors of perception open to new possibilities. We become ready for the next steps.
Step 4. Titration
Steps 3 and 4—pendulation and titration—together form a tightly-knit dyad that allows individuals to safely access and integrate critical survival-based, highly energetic states. Together, they allow trauma to be processed without overwhelm, and hence the individual is not retraumatized.
In Steps 5, 6 and 7, the gradual restoration of active defensive and protective responses—along with the carefully calibrated termination of the immobility reaction is accomplished. This, along with the discharge of bound energy, reduces the hyperarousal. Together these steps lie at the heart of transforming traum
a. In particular, the egress from immobility is associated with intense arousal-based sensations, along with the powerful emotions of rage and frantic, fearful flight. This is the reason the process of trauma release must be worked in tiny increments.
I use the term titration to denote the gradual, stepwise process of trauma renegotiation. This process operates like certain chemical reactions. Consider two glass beakers, one filled with hydrochloric acid (HCl) and the other with lye (NaOH). These extremely corrosive substances (the acid and the base, respectively) would cause severe burning if you were to place your finger in either beaker; indeed, if you were to leave that finger there for a few moments, it would simply dissolve since both of these chemicals are so caustic. Naturally, you would want to make them safe by neutralizing them; and, if you knew a little chemistry, you might mix them together to get a harmless mixture of water and common table salt, two of the basic building blocks of life. This reaction is written HCl + NaOH = NaCl + H20. If you simply poured them together, you would get a massive explosion, surely blinding yourself and any other individuals in the lab. On the other hand, if you skillfully use a glass valve (a stopcock), you could add one of the chemicals to the other one single drop at a time. And with each drop there would be a small “Alka-Seltzer fizzle,” but soon all would be calm. With each drop the same minimal reaction would repeat (see Figure 5.3). Finally, after a certain number of drops, both water and crystals of salt would begin to form. With several titrations, you would inevitably get the same neutralizing chemical reaction, but without the explosion. This is the effect that we want to achieve in resolving trauma: when dealing with potentially corrosive forces, therapists must somehow neutralize those sensations of intense “energy” and the primal emotional states of rage and non-directed flight without unleashing an explosive abreaction.
Titration
Figure 5.3 Titration in the chemistry lab is a way of combining two corrosive and potentially explosive substances in a controlled mixing that transforms the reactants gradually.
Step 5. Restoring active responses
During my accident, as I was propelled into the windshield of the car, my arm stiffened to ward off the impact to my head. The amount of energy that goes into such a protective response is vast; muscles stiffen to maximal exertion to fend off a lethal blow. Also, at the moment my shoulder smashed into the glass and I was propelled into the air and onto the road, my body went limp.
When your muscles “give up” like that and collapse, you feel helpless and defeated. However, underneath that collapse, those flaccid (hypotonic) muscles still carry the signals to protect you even though they have “lost” their power, liveliness and ability to do so.
Our human sensorimotor memory is poised and ready to carry out its marching orders to champion our protection and safety. In my case, with interoceptive awareness, the active bracing pattern was gradually restored, and energy began to return to my arms. I allowed my muscles to do what they had “wanted” to do and were prepared to do in the moment prior to impact before they collapsed into helplessness. Bringing that into consciousness allowed me to experience a deepening sense of empowerment. Similarly, twenty-four-year-old Nancy (my very first trauma client from Chapter 2) and I discovered, unwittingly, that (rather than continuing to feel overpowered and overwhelmed by the surgeons as she had at age four), she could now escape from being held down and terrorized. These new experiences contradicted and repaired both of our experiences of helpless terror.
Briefly, the way these active self-protective responses are reestablished is as follows: Specific tension patterns (as experienced through interoceptive awareness) “suggest” particular movements, which then can express themselves in minute or micro-movements. The positions that my arms and hands spontaneously and powerfully assumed during the accident had protected my head from smashing into the windshield and then from being cracked open on the pavement. Later, when I was in the ambulance, I revisited these instinctual reflexive movements and expanded them through sensation awareness—a process that allowed me to consciously experience the activation of muscle fibers as my body prepared for movement. These actions had previously been incomplete and remained nonconscious. By slamming forcefully, first into the windshield and then onto the pavement, these muscular reflexes had been truncated, leaving me with collapsed and constricted muscles and a vast reservoir of latent energy. Instead of feeling helpless and victimized by this dreadful event, I created a powerful sense of agency and mastery. In addition, the restoration of defensive responses has the effect of automatically titrating the energies of rage. In other words, the explosive energy that would be expressed as rage and non-directed flight was now channeled into effective, directed healthy aggression.
Empowerment derives directly from expelling the physical attitude of defeat and helplessness and restoring the biologically meaningful active defense system—that is, the embodied triumph of successful protection and the visceral actuality of competency. Such renegotiation (as we shall see in Step 6) also helps to dissolve the entrenched guilt and self-judgment that may be byproducts of helplessness and repressed/dissociated rage. By accessing an active and powerful experience, passivity of paralysis and collapse is countered.
Because of the central importance of restoring these lost (rather, misplaced) instinctive active responses in healing trauma, I will—at the risk of repetition—address this subject from a slightly different angle. It can be said that the experience of fear derives from the primitive responses to threat where escape is thwarted (i.e., in some way—actual or perceived—prevented or conflicted).54 Contrary to what you might expect, when one’s primary responses of fight-or-flight (or other protective actions) are executed freely, one does not necessarily experience fear, but rather the pure and powerful, primary sensations of fighting or fleeing. Recall, the response to threat involves an initial mobilization to fight or flee. It is only when that response fails that it “defaults” to one’s freezing or being “scared stiff” or to collapsing helplessly.
In my case, in the ambulance, it was in my limbs—in the micro-movements of my arms rising upward to protect my head from mortal injury—that I first felt an opposite experience that contradicted my sensation of helplessness. For Nancy, it was her legs running to escape the doctor’s surgical knife. In both cases, consciously feeling our way through these active self-protective reflexes with precision brought us the physical sense of agency and power. Together, these experiences countered our feelings of overwhelming helplessness. Step by step, our bodies learned that we were not helpless victims, that we had survived our ordeals, and that we were intact and alive to the core of our beings. Along with instilling active defensive responses (which reduces fear), individuals learn that when they experience the physical sensations of paralysis, it is with less and less fear—each time trauma loosens its grip. With such a body-based epiphany, the mind’s interpretation of what happened and the meaning of it to one’s life and who one is shifts profoundly.
Step 6. Uncoupling fear from immobility
My clinical observations, drawn from more than four decades of work with thousands of clients, have led me to the solid understanding that the “physio-logical” ability to go into, and then come out of, the innate (hard-wired) immobility response is the key both to avoiding the prolonged debilitating effects of trauma and to healing even entrenched symptoms.55 Basically, this is done by separating fear and helplessness from the (normally time-limited) biological immobility response as described in Chapter 4. For a traumatized individual, to be able to touch into his or her immobility sensations, even for a brief moment, restores self-paced termination and allows the “unwinding” of fear and freeze to begin.
Of equal importance in resolving trauma is therapeutic restraint in not allowing the unwinding to occur precipitously. As with the nontitrated chemical reaction, abrupt decoupling can be explosive, frightening and potentially retraumatizing to the client. Through titration, the client is gradually led into and out of the
immobility sensations many times, each time returning to a calming equilibrium (the “Alka-Seltzer fizzle”). In exiting from immobility, there is an “initiation by fire”; the intense energy-packed sensations that are biologically coupled with undirected flight and rage-counterattack are released. Understandably, people commonly fear both entering and exiting immobility, especially when they are not aware of the benefit of doing so. Let us look more deeply into these fears.
The fear of entering immobility: We avoid experiencing the sensations of immobility because of how powerful they are and how helpless and vulnerable they make us feel. Some of these even mimic the death state. When you consider how the thought of something as routine as being compelled to sit rigidly still in the dentist’s chair can cause you to wince, you begin to understand the challenge of voluntarily entering immobility mode. You may anticipate the pain of being trapped with no way to escape. For anxious or traumatized individuals, having to lie immobile during an MRI or CT scan can be downright terrifying. For children, these procedures may be vastly more difficult. Sitting quietly at one’s desk, unable to move for hours at a stretch, is a challenge for any youngster. For an anxious or “sensitive” child, it can be unbearable, perhaps even contributing to attention-deficit hyperactivity disorder. This may be especially true for children who have had to undergo immobilizing procedures, such as when casts or metal braces are required for orthopedic correction of hips, legs, ankles or feet during the developmental stage when a child would normally be learning how to walk, run and explore the world.
In an Unspoken Voice Page 10